MAZE Procedure Question

[ALCapshaw2]

I may need to have my Mitral Valve replaced due to progressive Mitral Stenosis which I suspect resulted from Radiation Treatment damage decades ago.

The Surgeon I am considering suggested including a MAZE preocedure when I saw him 2 years ago and was in A-Fib at the time. My A-Fib has virtually disappeared and I'm only taking 40 mg of Sotalol (generic for Betapace) once a day (usual recommendation is 80 mg twice a day since it is NOT available in time release form).

Bottom Line: It works for me and my Cardio wants me to continue, if for no other reason, to keep my body conditioned to it in case I the A-Fib returns and I need to increase my dose. My Cardio shakes his head at 1 dose/day but we are in agreement on the philosophy of using the minimum dose that works (on all meds).

SO, my question for anyone familiar with the MAZE procedure is:

What reasons are typically given for recommending a MAZE procedure?

I'm assume that existing A-Fib is a major contributor, but if that is not present, is the MAZE commonly used on patients receiving Mitral Valve Replacement? (Presumably because the AV Node is close to the Mitral Valve).

'AL Capshaw'

 

[Adrienne]

I can only tell you about my case. I was planning to have a mitral valve repair by this year at the latest. Then I went into A-Fib in August 2005 which I knew I was at risk for because of my enlarged atrium. Towards the end of August (to make a very long story short) my husband took me to the ER of the Montreal Heart Institute where I had already spoken to a surgeon in December 2004 and knew I wanted him as my surgeon. When they saw me in the ER, they kept me and said I was ready for the valve operation and they were going to do it the next week. Then I found out that my surgeon was leaving that weekend for Belgium for two weeks, so I could either have another surgeon do it right away or I could wait for Dr. Pellerin. I knew Dr. Pellerin was THE BEST, so I said I would wait. However, I did get to see him before he left, and he said that he would try to do a repair (which he did) and he would do a MAZE (I think he said a left MAZE). I have read that they will usually not open up a person if it is only for a MAZE but if the person is having a valve repaired or replaced, they will then do it if it needs to be done. Since I had just had A-Fib, and was cardioconverted in the hospital and then put on Amiodarone and other things to keep me stable until I had the operation, I was an excellent candidate. Since my operation, my heart has been is sinus rhythm. Between January and May, I was getting some extra systolic beats. I suppose that every once in a while I might still get a couple, but it's almost nothing. Since I have a fast heartbeat, I take an infinitessimal amount of Metroprolol (a beta blocker). Even this small amount lowers the HR very well without causing side effects.

I am presuming that the reason your surgeon suggests a MAZE even though you are not in A-Fib is that probably (although this I don't know, since I don't know what your left atrium measurement is) your atrium has dilated and that possibly even after the valve operation, there may be some risk of the A-Fib coming back.

I probably didn't help you that much, but that is what I surmise. By the way, what is the measurement of your left atrium?